Post Operative Care

What happens after nasal surgery

There are many types of nasal surgery, generally they fall into surgery on the septum (septoplasty); on the turbinates (turbinoplasty), in the sinuses (FESS – Functional Endoscopic Sinus Surgery).

What can I expect after I have nasal surgery?

The most common symptom after nasal surgery is blockage of the nose. Commonly after surgery of the nose, to prevent bleeding, dissolvable packing is used. This typically causes blockage of the nose, which improve with nasal washes that is prescribed after surgery. These packing starts to dissolve after 2 weeks. Occasionally nasal splints (small pieces of soft plastic) are used to keep the septum straight. These are removed at 1 week after surgery in the office.

After surgery, it takes approximately 6-8 weeks for the lining of the nose to recover and heal completely. During that time, crusting, discharge and blockage is relatively common.  In order to improve the healing of the nasal lining, it is important to use the nasal washes to wash away the crust and packing.

There is also frequently a small amount of bleeding, mostly mixed with the mucous that last for a few days. If bleeding is profuse and continues despite simple first aid (pinching the nose, sucking on ice) for 15min, then you need to contact your surgeon and present to your nearest emergency department or call an ambulance. Things that can cause bleeding include heavy lifting, strenuous exercise, blood thinning medications and anti-inflammatory medications.

How to use the nasal washes?

Do not blow your nose initially for the 1^st week. Blowing your nose can dislodge clots and packing and lead to bleeding. It is better to use the washes to cleanse the nose instead.

All patients after nasal procedures are given nasal washes to go home. These are large volume washes that are designed to dissolve packing and wash away the crusting and mucous that can occur after nasal surgery.  Typically it is used 4-6hourly into both nostrils, but they can be used as frequently as you like. Correct technique is to lean forward over a sink and gently squeeze the bottle through one nostril and letting it run out. Initially after surgery, the washes will not be able to penetrate very deep into the nose because of the packing. Once packing is dissolving, you should expect water to come out of the opposite nostril and even through your mouth.

Is it very painful after nasal surgery?

No, most nasal surgery does not cause a significant amount of pain. Simple pain-killers such as panadol or panadeine is all that is required. If there is uncontrolled pain, you should contact your doctor. It’s important to avoid aspirin and blood-thinning medications and anti-inflammatories (such as nurofen, ibuprofen) after surgery as they can cause bleeding.

What happens after removal of tonsils

What is tonsillectomy?

Tonsillectomy is an operation where the tonsils are removed through the mouth while a person is asleep.

What can I expect after I have tonsils removed?

The most common symptom after removal of tonsils is pain. Typically, the pain lasts for 10 days with the pain gradually increasing in intensity for the first 5 days and then gradually improving. Generally patient return to normal at the 2 week after surgery or even earlier.

What can I do to minimize the pain?

The most important thing to do after tonsillectomy is to eat and drink as normally as you can. Eating and drinking allows maintains hydration, cleans the tonsil wound and thus prevent the build up of scabs in the tonsil wound. Not eating and drinking leads to dehydration. It’s also important to eat high-fibre foods to prevent constipation that can occur as a side effect of the pain-killers

What type of food can I eat after tonsillectomy?

Generally any type of food is fine. Acidic, citric and spicy foods along with very hard foods such as toast can be sometimes difficult. Typically most people eat soft foods. If eating food is really difficult, it is critical to continue to drink lots of water, juice and soups to prevent dehydration. Dehydration leads to a vicious cycle where more pain prevents further eating and drinking, leading to further dehydration and continuing the cycle. Icy poles are excellent for both relief of pain and of providing hydrations. Try to time eating with just after a dose of pain relief will make eating and drinking easier.

What medications can I take to treat the pain?

Regular pain-killers are required. Everyone should have regular Panadol taken strictly irrespective whether there is pain or not. Regular Panadol provides a good baseline of pain relief and by taking it regularly; it can prevent the pain from taking hold. If there is still pain after taking Panadol then another type of pain-killers is usually required. In children this is typically Nurofen, in adults Celebrex and Endone is typically used. There is a theoretical risk of increased bleeding that can occur with non-steroidal anti-inflammatory drug (such as nurofen, ibuprofen and Celebrex) but this has not been shown in large studies. Nevertheless, these should be used sparingly. Opiod based pain-killers (such as Panadeine and Endone) can cause nausea and constipation. If needed, laxative such as lactulose can be used.

What happens if there is bleeding?

While bleeding after tonsillectomy is rare, it does occur. If the amount is very small for example: mixed in the saliva or a small clot, sucking on some ice usually stops it. If bleeding is more substantial, recurs or you are concerned please present to your nearest emergency department and contact your surgeon. Generally this is treated with overnight observation and some mouth gargles, but occasionally a trip back to the operating theatre may be required.